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A New Ally, or a New Frenemy?

So, I am verrrrry curious to read Gary Taubes’s new book, Good Calories, Bad Calories, after reading his recent articles in The New York Times Magazine (on the limitations of epidemiological studies — notably, our old friend Walter Willett’s Harvard Nurses Study) and New York Magazine (on why exercise won’t make you thin). Both are long and dense but well worth the read.

From the former (in which Taubes uses the conflicting beliefs about Hormone Replacement Therapy as his primary example), with my own emphasis:

The catch with observational studies like the Nurses’ Health Study, no matter how well designed and how many tens of thousands of subjects they might include, is that they have a fundamental limitation. They can distinguish associations between two events — that women who take H.R.T. have less heart disease, for instance, than women who don’t. But they cannot inherently determine causation — the conclusion that one event causes the other; that H.R.T. protects against heart disease. As a result, observational studies can only provide what researchers call hypothesis-generating evidence — what a defense attorney would call circumstantial evidence.

This just in: correlation does not equal causation! Kudos to Taubes for exploring that point in great depth, and kudos to the Times for publishing it, even if they’ve also been rather irritating this week.

Then, from the NY Magazine article (thanks to reader Kris for the link), we have this:

Just last month, the American Heart Association and the American College of Sports Medicine published joint guidelines for physical activity and health. They suggested that 30 minutes of moderate physical activity five days a week is necessary to “promote and maintain health.” What they didn’t say, though, was that more physical activity will lead us to lose weight. Indeed, the best they could say about the relationship between fat and exercise was this: “It is reasonable to assume that persons with relatively high daily energy expenditures would be less likely to gain weight over time, compared with those who have low energy expenditures. So far, data to support this hypothesis are not particularly compelling.” In other words, despite half a century of efforts to prove otherwise, scientists still can’t say that exercise will help keep off the pounds.

Ahhhhhh. Refreshing, ain’t it?

So I’m a big fan of Gary Taubes. So far.

Here are the things that make me worry. First, from the NYT article, we also have this, again with my emphasis:

One reason researchers believe that heart disease and many cancers can be prevented is because of observational evidence that the incidence of these diseases differ greatly in different populations and in the same populations over time. Breast cancer is not the scourge among Japanese women that it is among American women, but it takes only two generations in the United States before Japanese-Americans have the same breast cancer rates as any other ethnic group. This tells us that something about the American lifestyle or diet is a cause of breast cancer. Over the last 20 years, some two dozen large studies, the Nurses’ Health Study included, have so far failed to identify what that factor is. They may be inherently incapable of doing so. Nonetheless, we know that such a carcinogenic factor of diet or lifestyle exists, waiting to be identified.

We all know I’m no scientist, or even a science journalist, but what that tells me is that something about the American lifestyle, diet, or environment is a cause of breast cancer. And that such a carcinogenic factor, period, exists. Are as many Japanese women as Americans on the pill? Do Japanese women who move to the U.S. have babies later in life, or are they more likely to choose not to have children? Are they moving from the country to big cities? Are they exposed to more pollution? Does culture shock and/or the American work environment cause more stress? Do they drink more alcohol here? Some of these questions fall under the rubric of “lifestyle,” sure, but “lifestyle and diet” in contexts such as these always seems to come down to what you eat and how much you exercise — not how stressed out you are or how old you were when you had kids or where your house is located or how educated and monied your friends are or are not.

Which brings me to the second thing that makes me wary of Taubes: as you can guess by the title of his book, he’s got a problem with what we eat. Specifically, he’s arguing (according to the Amazon page) that refined carbs fuck up our health and make us fat, while saturated fat is not a problem. Not having read the book, I can’t comment on his argument yet — which might be compelling — but I also can’t help noticing how much that thumbnail description sounds like Atkins or South Beach. And since the Amazon page indicates that there’s a “Thus, the key to permanent weight loss is…” argument in there somewhere, I’m as leery of the book as I am intrigued by it. If he’s seriously arguing (and again, I don’t know that he is) that a high-protein, low-carb diet will lead to permanent weight loss and improved health, he really needs to read about the study Gina Kolata follows in Rethinking Thin. Or, you know, talk to anyone who started on Atkins or South Beach more than 5 years ago.

Nevertheless, based on the above-linked articles, I really admire Taubes’s skepticism and thoroughness, and I look forward to reading what he has to say about obesity research. I should also admit my own bias here (other than the screamingly obvious one): as a rule, I don’t dig books that say “Americans aren’t to blame for making themselves so fucking fat — Big Food is!” It’s why I lost interest in Fat Politics halfway through, why Fast Food Nation makes me cringe as much as it makes me want to never touch a french fry again, and why I’d really like to kick Morgan Spurlock in the shins. I’m most certainly no fan of Big Food, and like any good liberal, I am definitely inclined to believe that massive corporations would rather go ahead and poison us all within the bounds of the law than make any changes that threaten their profits. But A) I think we must be just as skeptical of studies that suggest that as those that suggest weighing 250 lbs. is the end of the world, even if the former appeal more to our sensibilities — after all, Cheez Whiz is arguably nature’s perfect food — and B) when the argument comes down to “THIS is what really makes people fat!” then it just reinforces the idea that being fat is intrinsically a terrible thing, and that the “obesity crisis” remains a real problem in need of a solution, not a load of fucking horseshit. “Being fat isn’t as bad as we’ve been led to believe — BUT ZOMG, HIGH FRUCTOSE CORN SYRUP IS WHAT’S MAKING US FAT!” isn’t an argument that’s going to advance the cause of fat acceptance a whole lot; it’s just going to move the goal posts and give fat people a different set of rules for eating that they must follow to please the gods of Good Health — and, of course, get less fat.

That doesn’t mean I think the people pumping us all full of HFCS shouldn’t be taken to task, or that there’s no chance that refined carbs in processed foods have contributed to the relatively modest increase in Americans’ weight over the last few decades or that foods loaded with them are less nutritious than meat and whole grains (or whatever the hell food is gonna be our salvation this week). Hell, I’d like to see HFCS go the way of the dodo just because real sugar tastes so much fucking better to me (but then, I’m not much of a sweet person). And since insulin resistance is about the only health problem that appears as if it might have a genuine relationship to fat — not just a coincidental one — and Taubes seems to be arguing that refined carbs cause both insulin resistance and fat, I’m even open to accepting his whole argument. But I remain wary of it. Seriously wary of it.

Having said that, I’ll go ahead and also say that I’m excited to see Gary Taubes getting attention either way. He may not be a true ally to fat acceptance activists, but at this point, I’ll cheerfully take a new frenemy in the public eye. I mean, as delighted as I was to see Paul Campos trounce Kelly Brownell in the L.A. Times last week (the whole series is a must-read if you haven’t gotten to it yet), as obesity researchers go, I’ll take a Kelly Brownell over a Walter Willett any damn day. Someone who meets us halfway, or a third of the way, is a whole lot better than someone who just wants to howl about how we’re making excuses and killing ourselves by eating too much and not exercising enough. I can’t wait to read Taubes’s book and see where he really falls on that continuum.

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77 thoughts on “A New Ally, or a New Frenemy?”

I have been lurking on your site for awhile, and I have to say I am big fan.

With regard to breast cancer specifically, I have wondered if the addition of Bovine Growth Hormones to our dairy is to blame. Cows injected with this produce very high levels of IGF-I in their milk, which is not destroyed in the pasteurization or digestion process, and is a naturally occuring hormone in humans which promotes cell division . Drinking (via milk) or eating (via cheese, yogurt, cottage cheese, ice cream, etc) this cannot be good for us, as it is a recognized tumor promoter. Also, old dairy cows are used to make the cheap hamburger that is sold via fast food establishments. The meat is full of IGF-I.

In mice, increased levels of IGF-I lead to “diabetic complications”. Do you think there could be a link between increased insulin production in the US population and the incidence of diabetes?

Anyway, no science in the above statement s- just conjecture and my two cents. Nevertheless, I actively seek out non-rBGH milk!!!

Thanks, QT! I was actually gonna bring up BGH on my list, but I forgot! (Well, and clearly it falls under the “what we eat” category, which would have made my argument annoyingly complicated, even if everyone around here knows that hormones in our food are not what journalists usually refer to when they lambaste the American diet.) It definitely occurred to me, too.

the relationship between physical activity and fatness comes down to the question of cause and effect. Is Lance Armstrong excessively lean because he burns off a few thousand calories a day cycling, or is he driven to expend that energy because his body is constitutionally set against storing calories as fat? If his fat tissue is resistant to accumulating calories, his body has little choice but to burn them as quickly as possible: what Rony and his contemporaries called the “activity impulse”—a physiological drive, not a conscious one. His body is telling him to get on his bike and ride, not his mind.

is a perspective I’ve never thought about before! I’d also never read the research about how LPL responds to excercise.

My husband and I watched Supersize Me not too long ago (yes, we’re late on the “zomg! trans fats!!” band wagon), before I learned anything about the fat acceptance movement. I remember thinking at the time that, while he certainly gained weight, it didn’t seem to be *that much* weight., which kind of scared the crap out of me. (I gained 70 pounds after I graduated from high school; if 20 pounds shuts down your kidneys, why aren’t I dead?)

Looking back on it with fresh eyes, it’s astonishing that all the health problems Spurlock developed over that month were conflated with the weight gain. It’s such a pity, because it buries legitimate discussion we as human beings might have about the actual, honest-to-god problems with fast food and how it is processed and produced.

I feel the same way about the South Beach Diet; that was my last dieting attempt (last summer). I do notice that I feel like absolute shit if I consume too many refined carbs during the day. But making adjustments accordingly (to a certain extent; I still luuuv mah chocolate) haven’t caused my weight to plumet. I’m healthier, but not thinner.

But really, it’s all about Teh Fat. Which is why it’s *okay* and even *sexy* for a skinny, hawt woman to bury her face into a Six Dollar Burger from Carl’s Jr.

The other problem, to my mind, with those big studies, is that the majority of the data, and in particular the nutritional info, is based on self-reports. And I don’t think I know anyone who would accurately write down exactly what they consume each day – either because they’re too hung up about it to admit it, or because they don’t really give a hoot and haven’t wasted any precious memory space on it.

I’m a respondent in the EPIC study (a big European study of the links between cancer and nutrition), but the questionnaires only come once every five years or so, and it’s a case of ticking the boxes for the ballpark figure, eg “how many servings of vegetables do you eat on average per day?” 0-3, 4-6, etc… which brings up all kinds of questions about how big a serving is, what’s an average day, blah blah blah, plus I bet most people feel so guilty if their fruit & veg doesn’t add up to five portions a day (our recommended Govt amount – it is set lower than it should be to make it “achievable”, but I gather in the US it is 7 servings for women, 9 for men….?) that they bump the numbers up a bit.

Obviously what we eat affects our health greatly, anyone who has made big (permanent) diet changes can attest to that. For example, refined sugar=horrible, painful period cramps for me. I don’t care if there is not a scientific explanation yet because the difference between rolling around the floor in the depths of pain and being able to function normally is pretty clear to my body. I have more examples from my personal life, and I’m only 23. And done with candy permanently, it’s been a few years since I’ve had any, it’s not worth it.

But I don’t see this meaning we can’t accept fat. Changing your diet permanently doesn’t mean you’ll lose weight (temporarily or permanently), it means you’ll get healthier. Health At Every Size, no? You do these diet and activity things regardless of how they affect your weight because they are good for you.

It does make sense that if someone is heavier/lighter than they should naturally be *at that time* (what is realistic with diet and exercise for them THEN), they won’t feel as well. But that’s not for any outsider to judge, they have no idea where a person is at or how they feel. Even we don’t know what we “should” be until we work realistically towards health, regardless of size.

We can still accept fat. The problem is that almost every woman feels bad psychologically for not being a stick with big breasts, and that has nothing to do with health. And people assume that if people are fat, they aren’t doing the right things. I guess it all comes down to Health At Every Size. (And of course, people have the right to do unhealthy things. It’s not an ethical issue).

Waa! Kate Harding read my post! Also, I love your blog and am bringing the FA message out there. The most vocal thing I’ve done to date for FA, was when I got dumped and rapidly lost ten pounds–no appetite, skinny girl! Everyone would tell me I looked great (some women said it *so* enviously) and everytime I would tell them I was too sad to eat, but constantly hungry, and the weight would come right back when I could eat like a functioning person (which it did). And women would relax a bit, like, okay, I’m not supposed to look like that because I’m not a dumped depressed starving woman. So I can see the skinny-for-bad-reasons angle just as much as the other end. And this blog is really inspiring me to keep the message out there, thank you!

Kate, I’m confused on why Schlosser’s argument that big food makes us unhealthy is wrong and judgmental? Because if a food makes people gain weight, then it’s inherently wrong? I can kinda see what you mean (if i’m inferring correctly), but i’m not going to dismiss him so easily, because i found his book important for so many other additional reasons.
I think his book forced people to have a real look at where food comes from; the suffering endured by the steer, perhaps having had it’s hide ripped off before it was dead, the migrant workers, employed by IBP, who are punished if they file injury claims, the environment surrounding CAFOs, mired literally in shit and methane….. It’s easy to turn a blind eye to the reality of where our food comes from. After all, it’s so much easier tear into something when you’re not thinking about the emotional, social, or environmental implications thereof. I think Schlosser illuminates these other factors intrinsic to our food supply that most people would choose to ignore. And i think that’s laudable.

You’re being glib about the cheese whiz? I hope? I wholeheartedly agree with Bobette that our own bodies should be the only science lab we need to determine what we should or should not eat. What is good for one human may disagree with the next. But i doubt, (and please speak up if you’re out there) that anyone would thrive on a diet of cheese whiz.

Wow, I thought that excercise article was really interesting until he absolutely sabotaged his credibility at the end.

Because if it’s all linked to our underlying homeostatic tendencies and insulin levels may play a role in how much fat we store…

wouldn’t it stand to reason that there may be underlying genetic tendencies to secrete more or less insulin as well??

It’s actually kind of pitiable how he writes a really interesting article contrary to the conventional wisdom and then does the same thing and lets his blind-faith existing preferences undermine his entire point.

Madge, I didn’t say Schlosser was wrong and judgmental. I actually really liked the book — though I haven’t read it again since getting fully into Fat Acceptance. All the points you mentioned are important and very well made in FFN. But if I recall correctly, he does go down the “obesity epidemic” road, which I have big problems with, even if I like a lot of his argument.

I’m being semi-glib about the Cheez Whiz — check out the link there (it’s to Sandy). I’m sure not saying I think babies should be fed Cheez Whiz for optimum health, but the article is an interesting challenge to our beliefs about processed food. The point that impressed me most there is how we’ve come to believe that fresh veggies are the be-all and end-all, when frozen and even canned veggies can pack even more of a nutritional punch. The Cheez Whiz argument, I can take or leave, but I love it as a thought experiment. :) Barry Glassner talks about the same kind of stuff in The Gospel of Food, too.

I know you’re a lot more into food politics than I am, so I do defer to your expertise, but I tend to be skeptical even of things that make intuitive sense to me or support my own political beliefs. (Like I said, I’m no fan of Big Food.) Sometimes, I have to be MORE skeptical of those things. If I’m going to complain about everybody else filtering science through their biases, I have to keep an eye on myself in that respect, too.

Hey, have you read Marion Nestle’s Food Politics? What did you think? I bought it recently but haven’t started it yet.

I don’t think that I would read his “diet and lifestyle” factors quite as tightly as you did. I think he means it much more broadly than food & exercise. For example, a few paragraphs down from the comment on Japanese and breast cancer, he lists some “lifestyle” factors that are known to cause disease:

“diet and lifestyle factors … smoking as a cause of lung cancer and cardiovascular disease, sun exposure for skin cancer, sexual activity to spread the papilloma virus that causes cervical cancer and perhaps alcohol for a few different cancers as well.”

It seems that in the light of science knowing how complex this and other “health” issues are, they keep attempting to simplify it, when they know they can’t. That tends be an area that I am really concerned with.

I went to a hospital about a week ago (Plantar fascittis… oh how I love thee). He saw that I was flat-footed, and while that is definitely a huge risk factor: He didn’t say much about my hobbies when I told him about what I do. Even after we had our little moment about styles (“What style do you do?” “Kyukido and Hapkido.” “I DO KENPO! OH YEA!” Lulzzzzz ): He still thought it was just my flat feet. Not because I kick people in the head on occasion, or the pattering of my feet on the ground when I run: It’s just the long arches. Pfft.

They should really weigh everything to make determinations. Sometimes I get annoyed by these attempts at identifying one thing as causation: Especially when it’s based around an assumption of sloth and gluttony with no actual observation of the patient.

Jon B., thanks! And I have to point out that if you were fat (another risk factor on the list for plantar fasciitis), that doc also would undoubtedly have told you to go on a diet to help ease the pain — still without considering what you actually do to your feet.

Here’s some food for thought: maybe what is different in the American environment is medical monitoring. You can often find a breast cancer on a mammogram before you can feel it. Has anybody compared the mammogram rate in Japan to the mammogram rate in the US? “Seek and you will find”, to some degree.

I am also sure that Asians who relocate here do not uniformly (if ever) convert over to a 100% American diet (whatever that is). This is just based on Asian families I know. I can say the same of Indian families, too. I wonder if there are any stats on breast cancer in Indian women.

True, Celeste, but what’s a “100% American diet” anyway? Is there really any such thing? People in this country love sushi and rice-based dishes too; when I was a kid, it was only Us Jews who loved to go for Chinese and were early adopters of sushi, now kids from Oklahoma love their California rolls.

Re Scholosser: His book annoyed me because of the ZOMG MCDONALDS IS MAKING US ALL FAT EXCEPT FOR ME BECAUSE I’M SO SMART angle. Especially irritating was when he said kids 6-10 years old were dying of heart attacks because of the “great weight” accumulated during their McDonald’s binges. Excuse me? Even if you believe in calorie voodoo, how could a 6-year-old possibly have eaten enough solid food over a lifetime for that to be the sole cause of a heart attack, unless it’s one of those ultra-rare genetic-freak cases like The Girl Who Had No Leptin? (Kolata reference.) I went and looked up the footnote related to that statistic, and the study in question said that 6-to-10-year-olds were dying of heart attacks related to their weight. Even that’s scientifically questionable, but “related to” is a whole lot different from “caused by.” Ehh, another yuppie fattist, pass.

Whether Taubes falls under Yuppie Fattist rubric remains to be seen, but I think I’ll let you have a crack at him before I do, KH, and you can let me know whether it’s “safe” to wade in.

That was part of my point, Meowser, about the American diet when I said, “whatever that is”. I don’t think that a sushi roll here and a trip to a Chinese restaurant there is analagous to a typical Asian meal at home. Restaurant portions are HUGE and don’t reflect the actual cuisine you would encounter in China, for example. Don’t forget about the American ethic of plate-cleaning, either. I don’t think we can assume that people of every nationality who come here to live embrace this philosophy. Americans have wacky ideas about how much food should be included in a meal.

In Chinese restaurants, though, portions have traditionally been huge because they were meant to be ordered “family style,” not all consumed by one individual at a sitting. When I and my brother would go out to Chinese with my parents, the meal would typically be two eggrolls split so each of us got a half, a small soup each, two entrees and rice split four ways, and maybe a small scoop of ice cream for dessert. And we drank tea and water (my parents didn’t let us order soda because they thought it was tacky to have soda with Chinese food). A big meal, sure, but a relatively rare treat, and when I hear people scream about “1240 CALORIES IN AN ORDER OF KUNG PAO CHICKEN ZOMG THE SKY IS FALLING,” I have to laugh, because I couldn’t eat a whole order in one sitting if you forced me to at gunpoint. Yeah, very different from how the Chinese eat, but that’s because Chinese chefs in Western countries learned their trade mostly in Hong Kong and adopted dishes to suit Western palates.

Yeah, when I used to go for Chinese with my family, we’d order 5 dishes with rice and share them, but we’d always bring at least half the food home. I don’t think there are many people out there going for Chinese alone, getting one order of ginger beef and just sitting there eating the whole thing. That’s just not how Chinese restaurants in North America work.

And is Taubes actually implying that a vegetarian or vegan diet is a big health risk? It’s pretty much impossible to do an Atkins or South Beach type of regime if you are vegan, and even an ovo-lacto would have very limited choices. Also, if the Japanese have such low rates of breast cancer compared to Americans, might all that (white) rice be protective somehow, instead of detrimental? Hmm?

For more on the idea that refined carbs make us fat and saturated fat is perfectly healthy, check out Nina Planck’s book “Real Food.” It makes sense when you think of it in this way: in the past 100 years, the American diet is almost completely processed with tons of refined carbs and hydrogenated oils, and cancer and obesity have sky-rocketed. When our great, great grandparents ate naturally farm-raised food (not feedlot meat or chemical-laced produce), they were much healthier–and thinner.

I’ve started shifting my diet towards real food for health reasons, but I am hoping that it ultimately results in weight loss. I’m eating full-fat milk (unprocessed and straight from the cow), naturally raised meat (including saturated-fat beef), and I’ve never felt better! I have so much more energy. My skin is soft and supple with NO breakouts! And without all the processed foods, my body shrank immediately, which I believe is due to the fact that processed and packaged foods have a lot of salt that causes water retention.

Of course, no one suggests binging on bacon and steak. But there is a whole counter-culture movement around real food right now, and it’s supporters are all about health (NOT thin vs fat.) I am absolutely loving it!

Then how to explain my boyfriend, who eats very little protein and lots of carbs and is not only pencil thin but enjoys nearly perfect health?

And I do NOT believe people were healthier 50 or 70 years ago. You can’t even make an apples-to-apples comparison, because lots of people were felled by infectious diseases then and didn’t even get a chance to live long enough to die of cancer. Furthermore, the survival rates on people who did get cancer and heart disease were tiny compared to what they are today. It was very common as recently as 30 years ago for people in their mid-50s to have their first heart attack while sitting in front of the TV and die right there on the spot; today that cohort is minuscule.

Eat the way you want to eat. But until I stop hearing from 95-year-olds who love their Twinkies and bacon, I’m not gonna believe in one-diet-fits-all, not by a long shot.

I’m not saying that to undermine your arguments about “real food,” which I don’t necessarily disagree with. But I think it’s important to keep pointing out that, no matter how many times we’re told that cancer, heart disease, diabetes, and of course obesity are SO MUCH WORSE THAN EVER BEFORE, the fact remains that we’re also living much longer than ever before. And there’s no evidence whatsoever that that won’t continue, despite all the “this generation won’t live as long as their parents” bullshit.

My original point is that there is research that clearly concludes it is not saturated fat that makes people fat. To read more about it, pick up Nina Planck’s book or check out the Weston Price Foundation. I think this is actually quite liberating! No more guilt over butter, steak, bacon, cheese, etc.

And yes, we are living longer than ever before. But to further illustrate my point: my Irish grandparents ate 95% “real food.” The only processed stuff they ate was an occasional piece of candy. They both got cancer in their 80s and died. But they were also both active and happy (almost) until the very end.

My other set of grandparents ate lots of processed food, lots of refined carbs. They both had numerous heart attacks. My grandfather was sick for years before dying, and my grandmother is has been withering away for years. I’ve often said I’d rather live to 80 and be healthy and happy than live to 90 and be sick. Surely, some of this is genetics. But I truly believe that food absolutely has an affect on health.

I don’t believe in diets. Although my main goal is health, I would be lying if I said I didn’t care about losing weight. I wish I didn’t care as much as I do…

My whole point here is NOT to tell anyone how to eat, just to relay my experiences and thoughts. I can’t speak to obesity statistics, but I can speak to cancer statistics. It’s not just old people who are dying from cancer, it’s young people, too. Breast cancer and prostate cancer have increasing significantly in the past 2 decades.

In my mind, it makes perfect sense: we’re loading up our bodies with food that is altered from it’s naturally occurring state (refined carbs), butter substitutes that alter natural fat into an unnatural fat, and fattening up our meats with the foods that they don’t naturally eat (cattle should eat grass, not corn.)

In America today, it’s *really hard* to avoid processed food. I’m at about 70% real food, 30% other. But that shift has made a profound difference. And I get to eat really good food without guilt, too!

Once again I want to (possibly annoyingly, heh) point out that things such as bovine growth hormone, hormones fed to other food animals, and high fructose corn syrup are just not used in Australia (BGH is actually banned), we have different tastes in fast food and food in general – and yet we have quite similar levels of breast cancer, ‘obesity’, early puberty in girls, and so on. Which is why I am pretty skeptical of certain claims about certain food.

Corollary to what I said about 95-year-olds above: I’ve also never heard of one who said they’d rather be eating Twinkies and bacon, but instead were living on brown rice and lentils because it was supposed to be good for them.

And can I see some numbers, please, about the so-called skyrocketing rates of cancer in the past 20 years in all age groups? My impression was that cancer death rates over that period were down, way way way down, so if you have information I don’t have, SMTD.

And were people eating much more “whole” food in 1985? Or 1975? Not that I recall. In fact, I remember my brother coming home from school and complaining that he was the only kid in his class who didn’t get white bread and snack cakes in his lunch or get to have sugary cereal for breakfast. People have been eating TV dinners and frozen pizzas and dehydrated this and reconstituted that by the truckload for about 60 years or so, so if there is a huge jump in cancer rates in the last 20 years, even in the very young, there has to be another cause besides that. Like environmental pollutants, perhaps? Or maybe fewer people dying of heart disease, polio, diphtheria, black lung disease, and even flu? You have to die of something after all, your heart doesn’t just randomly stop for no reason.

I don’t believe in diets. Although my main goal is health, I would be lying if I said I didn’t care about losing weight. I wish I didn’t care as much as I do…

My whole point here is NOT to tell anyone how to eat, just to relay my experiences and thoughts.

Jen K, we don’t talk about wanting to lose weight on this blog, period. Heidi got a day pass. Otherwise, it’s not allowed.

I’m not trying to be a bitch, just explaining that while relaying your experiences is always welcome here, relaying the part about wanting to lose weight isn’t. That’s not how we roll around here.

As to the rest of what you’re saying, again, I don’t necessarily disagree. I just don’t necessarily agree, either. I think the jury’s still out on a LOT of things, foodwise. And while I think you’re making some good points, I think Meowser and La Di Da are, too.

Speaking of which, La Di Da, I’m glad you repeated yourself about that, because I haven’t seen you say it before. Verrry interesting.

Jen, real liberation would be to stop feeling guilty for eating, period. You shouldn’t need somebody to tell you: “It’s okay to eat this, it’s good for you.” And come on, you can’t take two anecdotes and use them as proof that processed foods are bad for you.

Kate, your point is well taken about fat acceptance. I apologize. I was trying to convey that I am pro-fat acceptance, but still trying to shake off years of conditioning. I really am sorry that I offended.

Becky, you’re totally right. Real liberation is about not feeling guilty. Wish I could say I was there! But let me clarify, the guilt about saturated fat is around that dreaded “high cholesterol” threat, not being fat.

I seem to be making enemies here and it’s not at all my intention. I LOVE shapely prose and I LOVE fat acceptance. You are all role models and wonderful examples for those of us who want to be further along in the process than we are.

Meowser, I will get those statistics on breast and prostate cancer and post them.

Essentially, I’m trying to say that I’m finding the real food thing is an excellent fit for me, and I understand where it’s supporters (like the Food Politics) chick are coming from. It’s not about dieting, and it’s not about eating low-carb. (Perhaps for some real die-hards it is, but not for me.) It’s about learning how to trust your body and let it eat what it wants, even if your doctor tells you not to eat red meat or butter.

Exactly, KH. We don’t know a lot of things, and the frame keeps shifting. If 20 years ago margarine was “better” for us than butter and now margarine is poison that we shouldn’t even think about thinking about eating, if they’ve gone back and forth between whether frying in lard causes more heart disease than frying in vegetable oil, if one minute we’re supposed to be vegans and the next minute we’re supposed to eat nothing but free-range beef and fromage blanc, how can we trust any answer about food as definitive? It should be obvious to anyone who thinks, that all bodies are different and thrive on different things, and that a very wide range of weights and health outcomes results from the same “lifestyle behaviors” from person to person. But that idea is too much for most people, it seems — too scary, too random.

Now it’s hype about organic, organic, organic; I totally expect someone any day now to come along and tell us that even our organic veggies aren’t worth the recycled cardboard boxes they’re shipped in nutritionally because our topsoil is total crap. And I actually buy organic, although I’ll take local produce that’s not certified over stuff they have to fly in from Mexico that is, just because it frigging tastes better when it hasn’t been sitting in a box for a month.

Even there I acknowledge that my situation is unique, that most people aren’t living in areas as agriculturally and distributionally (is that a word?) blessed as mine, where farmer’s markets are abundant and that giant peach that costs $1.75 is ten times better than the two smaller ones you could get at Freddie’s for 85 cents each. I mean, shit, my mother lives in south Florida, and she says you can’t buy a Florida orange there, they all get shipped out of state. That’s whacked. And she certainly has the money for them.

No worries Jen, I’m glad you’ve found what works for your body! I’d just be wary of stating or implying that if other people don’t follow your lead and cut out processed foods they’ll end up with cancer. Because you really have no way of knowing that.

And for the record, wow, I didn’t realize that’s what I might have implied! I appreciate the feedback….

I understand/side with Taube’s argument about refined carbs and I do believe that they are a huge part of the reason why our society has health problems. (And I do think we, as a society, have health problems.) But I would NEVER want to imply that people “should” cut out anything. I’m sick of being told what I “should” eat, also.

And thanks, too, Kate. It’s actually very helpful feedback and forces me to look at my own fat acceptance. It’s good to get that mirror held up once in a while…it forces you (read:me) to be honest with yourself!

Can we please lay off the Pill? It’s the only thing that has managed to damp down the pain enough to make my life bearable, and I get scared whenever people start blaming it for things like breast cancer.

Rachel, I’m on the pill and a big, big fan of it — even though I also smoke, so I should be dropping dead some time in the next few years, apparently. I’m definitely not knocking the pill. All I’m saying is, there’s a correlation between lady hormones and breast cancer, so it’s one possible risk factor on a long list of them.

And the other thing to remember is, every individual needs to weigh the risks and benefits of any given treatment. In your case, the chance that you’d be in unbearable pain if you went off the pill is extremely high, while the chance that you’ll get breast cancer if you stay on it is pretty darn small. To me, that’s a very good reason to stay on it. If, however, you had a strong family history of breast cancer, and you were only on the pill because you don’t dig condoms, it might be more logical to go off it.

I think we’re all well aware that if a company or an organization wants to find a specific result, they can easily tailor a study to produce it! But I think this info is at least some food for thought…

Thanks Jen. But I still don’t see any of the following in those links:

– Incidence of breast and prostate versus other types of cancers (especially lung cancer) since 1975.

– Rates broken out by age group, socioeconomic status, and race.

– Comparison over the same period of cancer rates to other countries, such as Australia, where growth hormones and HFCS are almost impossible to find in food.

– Comparison of death rates from those cancers to all other types over the same period, as well as from heart disease. IOW, it seems to me that if there are fewer cases of lung cancer (which is almost always fatal) and fewer premature deaths from heart disease, the incidence from some other kinds will probably go up, because the single greatest risk factor for both breast and prostate cancer is aging.

Then put the pill at the bottom of the list. Leave it off completely, even. The last thing we need is another drug scare. The FDA isn’t going to care about my quality of life if they decide to pull the pill off the shelves.

Kate, i DID read Nestle’s Food Politics (well, i’m about halfway through), and I can surmise that it’s gonna piss you off.
She’s all about the “obesity EPIDEMIC” (insert boogeyman noises when saying those words) and even goes so far as to call it a SCANDAL.
I do appreciate her candor regarding her unique position in all of this – how she is able to cast aspersions at big food – due to her cushy, secure job at NYU. I also find her presentation of the work fantastic, as she has written this book for nutrition scholars and plebs alike (her appendix provides a crash course).
I personally umbrage with NYU – which has NOTHING to do with Marion Nestle, this book, or even their nutrition and food science department. Those lofty fucks will only accept transfer credits from “approved” schools when one is doing pre-reqs. of course they prefer you to take them at NYU for 1500 per credit. That school is in the business of making money, so i’m a bit suspect of anything that comes out of there. I know all U’s are like that to some degree, but that place is the extreme version of everything. Sorry to any NYU’ers i’ve offended, but you have to admit the policy of that place smacks of elitism. So happy reading!

Based on the audio online, I would put Taubes in the “frenemy” category. He’s so frustratingly close, but not quite there. Aware that size is not about fat people being lazy slobs, that the conventional wisdom about what makes people fat is totally wrong, and that permanent weight loss is nearly impossible for most people, But then he says that if people just tried hard enough and went about it the “right” way, they could lose weight.

I’m still interested in listening to the whole interview this weekend, and reading his book, but I’m going to be a cheapskate and wait until the local library gets it :)

also, I should mention that I know the hosts of the People’s Pharmacy. Unfortunately I couldn’t even call them “frenemy” to the idea of HAES. I think they think it’s possible for large people to be healthy, but that being smaller would make everyone healthier. F’rinstance they talk about the dreaded “obesity epidemic” in the Taubes interview.

But I still don’t see any of the following in those links: – Incidence of breast and prostate versus other types of cancers (especially lung cancer) since 1975.

If you look at the actual cited study, the study pins the recent increases in female breast cancer and prostate cancer rates on improved detection (mammography and PSA. They say that breast cancer rates may be due to “perhaps an increased prevalence of obesity and the use of hormone replacement therapy.” (“Perhaps” meaning there isn’t really solid evidence to back it up.) The rate of increase of breast cancer diagnosis has decline significantly in the past 10 years, so if there is an environmental factor, its effect is leveling off.

Lung cancer rates correlate directly with smoking rates and are in decline.

As an NYU-er, Madge, I’m not offended at all. They’ve never given a shit about their students and they never will, especially the undergrads. I remember one T-shirt sold by one of the NYU frats upon the school’s sesquicentennial: “New York Scruniversity: 150 Years Old and Still Screwing.” I wore mine with pride.

And thanks, Peggy, for providing further linkage. Yeah, when you look for something under every rock with a Geiger counter, you’re going to see a lot more of it, aren’t you? And if breast cancer rates have leveled off while “obesity” is still “skyrocketing,” that would seem to rule out fatness (or HFCS or growth hormones in beef cattle, for that matter) as a direct cause of the disease.

Oh, and totally off topic: It really bugs me when people talk about “Asians” as if they are a monolithic group and “Asian food” as if Japanese and Korean and Thai and “Chinese” people all eat the same way.

Gary Taubes seems to really vilify carbs. Near the end of Does Exercise Really Make Us Thinner he says “Put simply, it’s quite possible that the foods—potatoes, pasta, rice, bread, pastries, sweets, soda, and beer—that our parents always thought were fattening (back when the medical specialists treating obesity believed that exercise made us hungry) really are fattening. And so if we avoid these foods specifically, we may find our weights more in line with our desires.” and his What If It’s All Been a Big Fat Lie? is totally devoted to condemning carbs. It’s great and all to have someone combating the myth that we must all be lazy slobs since we’re not skinny, and tell us we’re not broken because we did that crazy exercise and are still fat, but telling us we all need to avoid carbs isn’t any better. I really can’t stand the whole war on carbs. Have any of these guys ever heard of eating a balanced, varied diet, or maybe just eating what makes you feel good?

It’s such a laugh to me when people tell me to avoid bread. Bread, the staple of human civilizations since human civilization was invented.

NO KIDDING.

And rice! Whose parents thought rice was fattening? I love that he puts these things on the same list as “pastries, sweets, soda, and beer.” I really don’t recall my parents telling me not to eat “bad” shit like Twinkies and Pepsi AND RICE.

Heh. The “we used to be thin and healthy” arguments always confuse me. People live longer now so how does that fit? So back then, people were healthier but died younger? :::scratch head:::: I mean, if we’re fatter than ever, but living longer than ever, doesn’t that sound like being fat might actually be good for us? Nah, can’t be that ;-)

My great grandmother (born in the 19th century) was fat. My grandmother (born 1921) was fat *and* suffered from digestive issues her entire life. I’m more than a bit sceptical when people talk of how thin and healthy everyone used to be.

And I had to laugh. Having just this year found out I’m gluten intolerant (and my mother, and likely my fat grandma was) I’ll pass on the staff of life, thank you ;-) But mmmmmmmm, rice = good :-D

I’ve been slowly working my way through “Good Calories, Bad Calories” (or as I’ve been calling it, “Good Toast Bad Toast”) this week. I’m not so far along that I can talk about the book as a whole.

I did buy the book in part based on the excitement on low-carb blogs (why are you reading low-carb blogs? you might ask…I’ll get to that). I’m a sucker for science journalism in general, my all-time favorite book is Laurie Garrett’s “The Coming Plague”.

I’m a little conflicted on the low-carb message. On the one hand, I don’t think it’s appropriate to tell anyone what they *should* eat…and as far as I’ve read so far, Taube often points out that the government’s choice to do that before data was adequately collected may have done more harm than good. On the other hand, more information about how things might work is always good. People deserve the opportunity to be informed eaters.

For me personally…I always thought low-carb diets were silly. I saw too much yoyo dieting and brain fog and of course 9 million disgusting Atkin’s products sweetened with glycerin (wtf? It’s *soap*, people!). However, for me personally at this time in my life, with a new hormonal birth control method driving me into hypoglycemic craziness, low-carb eating has let me feel like a human again with basically zero effort or expense. I enjoy the food I’m eating — I’m essentially a salad-with-meat-on-it type person anyway — but I really hate the appearance of dieting and the approving commentary that comes with it. I feel like in some way I’m betraying my ideals…but I’m a big fan of not being crazy. So, y’know.

(BTW, Kate, I’ve been reading here for a week or two and really enjoying it. Thanks!)

I stumbled upon your site today doing a search on Taubes’ name, so, I am not a long time reader of your blog. But, based upon this post and your (perceived) advocacy of “fat acceptance,” I am going to guess that you, generally, advocate “fat acceptance.”

I decided to post, primarily, to encourage you and your readers to actually read Gary’s book before you come to any conclusions.

I am a 42 year old male that has struggled with my weight my entire life. I am currently at almost 300 lbs (5’10). So, I am, obviously, all for accepting overweight people.

But…

The thesis of Gary’s book is that it MAY be true that a diet low in carbs can produce long-term weight loss and health for many that are chronically obese.

This 600+ page book is NOT a diet book. It is a fascinating explanation of how our “public health officials” have decided to propagate the low fat/high carb diet as the ONLY reasonable approach.

It is, in many ways, written directly to the medical/public health community…in an effort to force them to consider REAL, scientific exploration of an alternative theory (low carb).

I think your use of the term “frenemy” is a brilliant usage, especially if you haven’t finished Gary’s book yet, because you are correct that Gary is one of the few “voices in the wilderness” that is even proposing the concept that obesity is the cause of overeating and lack of exercise..not the other way around.

But…Gary does at least propose the theory that reducing insulin in the system can (maybe) provide a mechanism to produce fat loss and health.

If the public health standard line (low fat) and Gary (low carb) both end up being wrong (no dietary approach can produce long-term weight loss and health) than your battle for “fat acceptance is a valid fight.

But, after reading Gary’s book, it is hard to believe that (so far) we just don’t know.

Just as Gary chastises the current “party line,” I would encourage you (and your readers) to not yet give up hope that there is (some) scientific/dietary hope for us.

If the public health standard line (low fat) and Gary (low carb) both end up being wrong (no dietary approach can produce long-term weight loss and health) than your battle for “fat acceptance is a valid fight.

I’m sorry… so if they don’t, then it isn’t?

I would encourage you (and your readers) to not yet give up hope that there is (some) scientific/dietary hope for us.

Yeah, it’s a little tl;dr. And I’m not 100% sure it’s not a sock puppet. But the take-home message is that Robert is laboring under the misconception that body acceptance is a movement born of desperation, a sort of “I’m stuck with this fat body so I guess I’ll have to learn to live with it” thing. Sort of like how the gay rights movement is predicated on the idea that, since we apparently can’t train, bribe, or lobotomize people to be straight, we have to grudgingly tolerate variance in sexual preference. In fact, pretty much every activist movement is run by people who are just trying to sublimate their failure at being thin, white, rich, and male!

Robert, I think you just flew on through, but on the chance that you stuck around: If following Gary’s program is making you feel good, then I’m very happy for you. But it might still behoove you to stick around here for a while with your eyes open. You say you’re “all for accepting overweight people” because you are fat; I think you’re all for tolerating fat, while trying to get rid of it. There are more fulfilling options available to you.

I know that I may have stepped into a longstanding discussion that I do not fully understand (fat acceptance). If I did it ungracefully, I apologize. I DO NOT fully understand all (or most) of the “fat acceptance” tenants.

But…

I would have to assume that no one is arguing for accepting an unhealthy state.

Why I thought Gary’s book was so courageous is that he challenges MANY assumptions about what does/does not make us healthier/live longer. And, he does it based upon (his interpretation) of the science.

If part of the “fat acceptance” mindset/tenants is that being overweight has NO impact on health and/or longevity and you are able to demonstrate this scientifically, then KUDOS to your willingness to challenge conventional wisdom.

But, just as many of the people that Gary pokes in his book ASSUME that obesity is a simple calories in/calories out equation, I am ASSUMING that there is fairly good science to back up the hypothesis that excess weight IS unhealthy.

Again, I may need to poke through the rest of the blog to find references to such studies, but I ASSUME that most agree that excess fat has deleterious effects on overall health and longevity.

I am married and the father of four. I am (almost) beyond the vanity reasons for caring about losing weight. It is the negative physical and emotional consequences that I no longer wish to tolerate (lethargy, depression, inability to participate in sports I enjoy). And, again, my opinion is my own. I have been relatively thin and now am not. In my opinion, I experience these detrimental effects. I assume this is not the case for all.

Although I may be wrong, I really don’t feel that I am in the “all for tolerating fat” camp for any cultural reasons. I happen to find larger women more attractive than skinny women. I have very honestly expressed this “preference” to my wife. But, based on the evidence that ( I think) I have seen. I would still be concerned about her long-term health…if she were to become too obese.

And, I think it is unrealistic to ask someone to “accept” that they can no longer participate in things that they truly love, simply because they are obese…and be happy about it.

I love sex. Sex is less enjoyable at my current weight. Not because of vanity…because of physics.

I love martial arts and basketball and riding bikes…none of which I can comfortably participate in right now.

But, just as many of the people that Gary pokes in his book ASSUME that obesity is a simple calories in/calories out equation, I am ASSUMING that there is fairly good science to back up the hypothesis that excess weight IS unhealthy.

You’d be surprised! Check out the “But don’t you realize fat is unhealthy?” tag at the top of this blog.

Meanwhile, of course you should try to live the best you can in the body you have. I do encourage you to consider the fact that, as a father of four… oh Robert, I’m so sorry to say this, but you’re probably over 30. Possibly even over 40. *whispers* Sometimes things get more tiring.

I’m going to assume that we have scientific proof that aging can have some negative physical and emotional consequences. :)

Ok, I tease, but I do honestly think that one of the effects of fat panic is that people scapegoat the effects of illness, aging, and poor habits onto fat. There’s a lot to read around here on the subject — check out the HAES tag in the sidebar. Meanwhile, I’m glad you stuck around with an open mind.

Ok, I tease, but I do honestly think that one of the effects of fat panic is that people scapegoat the effects of illness, aging, and poor habits onto fat.

Absolutely. I am so sick of hearing people (not you, Robert) say, “When I was 20 and weighed X, I could do all these things, but now I weigh Y and I can’t!” Never putting it together that “now” is 10, 20, 30 years later, and that might just have something to do with it.

I’m 32, and a lot of things aren’t as easy as they were when I was just about the exact same weight at 25 — let alone when I was thinner and, you know, SIXTEEN. But then, a whole lot of other things — such as not hating myself and not listening to fatphobic assholes — are much easier now. It’s a trade-off I’m cool with.

But from what I skimmed so far, I think you’ll be amazed at how prescient your post is…especially after reading Gary’s book.

But, again, the reason I respect Gary’s courage (and yours) is that he is not blindly accepting the “politically correct” interpretation of the science; he is asking us to reconsider/do more real science/research.

I think it is necessary, though, to fully deal with the “carb” part of Gary’s hypothesis.

He is NOT just recommending a low carb diet…so we can lose weight. It is a 600+ page book and there is nothing in the book that slightly resembles a diet book. He is recommending a low carb diet because his interpretation of the science tells him that carb consumption (not necessarily obesity) is the nutritional evil.

He is NOT saying eat less carbs…lose weight…you’ll be healthier because you weigh less.

He is saying (irrespective of your weight/fat levels) too much insulin in our systems is dangerous.

If you ( or your readers) are disagreeing with the concept of “fat equals unhealthy,” you may (or may not) be correct.

But, if you were to agree with Gary’s interpretation of of the science, you would probably consider reducing insulin’s role in your daily life…and the easiest way to do this is by lowering carb intake.

Whether you did or did not lose weight, you might still consider lowering carbs…because insulin is bad.

Robert, as I said, I haven’t read the book yet, but I’m going to. I can’t really discuss this with you any further without having read the book.

But for the record, my post isn’t prescient — it’s all old news, really. :) It’s just that the results of studies are frequently spun by both the researchers and the mainstream media to make fat seem much worse than it is — and studies that show different results are rarely reported. That’s starting to change, with books like Paul Campos’s The Diet Myth and Gina Kolata’s Rethinking Thin — and now Taubes’s new book. But much of this info has been known since at least the ’50s.

Hi Kate, I stumbled upon your site like Robert did, looking for discussions about Taubes’ book. I have a background in science and work in medicine. I read the book. It confirms what I see every day at work. People who have elevated insulin and triglcyerides have more fat. If you are heathly and fat as you said, who cares?

If your insulin is under 8 and your triglcyerides are under 150 and you don’t have a Pattern B LDL subparticle profile, elevated fibrinogen or CRP you are probably pretty healthy no matter what size you are.

I was recently diagnosed with hypothyroid and am menopausal. Hello fat! My lipid profile is great, no elevated glucose or insulin levels. I rather enjoy my new curves and as long as my metabolic markers remain healthy and my arthritis is not made worse by the weight why worry? By the way, worry increases cortisol hormone which increases insulin which might increase fat deposition.

I exercise to keep my mitochondria healthy and my hormones healthy. What happens to my size and shape is genetic and irrelevant to my health.

I’ve read the entire Taubes book, and am a fat person myself (admittedly one who is working on becoming less so), so a couple of points about your post:

1. Taubes does take the point of view that being obese is not a good thing, but his position is quite nuanced, and he’s far from being an opponent of fat acceptance (which doesn’t come up in the book at all, this is just my sense from the overall tone of what he’s writing)

2. Taubes points out (and cites the relevant data) that obesity is not a cause but a concurrent symptom of a metabolic syndrome brought on IN SOME PEOPLE by eating a western type of diet that contains many simple carbohydrates. He spends a lot of time showing how in cultures around the world that were not exposed to western ideas of eating & western foods, diabetes (and cancer) was almost nonexistent, as was obesity; once these cultures had their food traditions interrupted by western influences (or the people emigrated to western countries), diabetes rates skyrocketed. (Whether you want to argue that obesity is on the increase or even bad at all, I don’t think anyone is defending diabetes — which is on the rise worldwide — as a neutral condition to have.)

3. Taubes sees the diabetic state as the extreme end of a continuum of health that we’re all on, and that the western style of eating in general has a tendency to promote, due to the marked change since the middle of the 19th century in the way people in the western world eat — a marked demonstrable increase in the pounds of sugar consumed per capita per year in the last 150 years. He shows the data that points to sugar as having seriously adverse effects on most physical systems due to its activation of insulin. And again, he makes the point that not every single person is as susceptible to insulin resistence as every other — otherwise we’d all be diabetic. But for that percentage of people who are very susceptible, the standard western diet may be poisonous.

4. He also shows how the recommendations of the last 40 years to eat a low fat high carb diet for “heart health” is in fact one that leads to cardiovascular disease, diabetes, and an increase in obesity, obesity being, as he shows, an additional symptom rather than a cause. And he shows why calories from carbohydrate cause people to lay on fat in a way that is unique compared to calories from protein and fat — ie, that a calorie is not a calorie, and that merely restricting calories while still eating a lot of carboydrate just makes a dieter tired without actually taking off any weight.

I recommend checking out the book’s epilogue first, which lays out the whole thesis, and then reading the book as a whole from the beginning.

Hi, I’ve been reading your site, this and the-f-word.org. I first found out about fat acceptance in 2006, stumbling across bigfatblog.com. I am supportive of Health at Every Size and combating bigotry in all its forms.

I just have to say I am a huge fan of Gary Taubes. His pieces “What If It’s All Been a Big Fat Lie?” and “The Soft Science of Dietary Fat” changed my life – because I became more healthy. I own his book but I had somehow missed the publication of two articles referenced in the post, so thank you for that.

I wanted to make a comment about bread. My reading has brought to my attention the difference between bread in its most common, cheapest, and most profitable form these days – and old fashioned bread, the kind that has existed as long as human civilization. Older bread was dark, thick, directly from cooking grains, often water-softened and sprouted grains. New white bread is made from flour that has been stripped of its fiber and additives we do not yet know the exact effect of, for better or worse – it’s just different.